Anatomy of the Nasolabial Fold

Rubin, Leonard R.; Mishriki, Yehia Y.; Lee, Gene

doi:10.1097/00006534-198901000-00002

Plastic and Reconstructive Surgery

1989

DOI: 10.1097/00006534-198901000-00002

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Anatomy of the Nasolabial Fold

Leonard R. Rubin¹,

Yehia Y. Mishriki²,

Gene Lee³

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2024

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Cited by 5 publications

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“…The nasolabial fold (NLF) is an important central facial landmark and is the linchpin of the smiling mechanism. 1 Loss or effacement of the NLF has been shown to contribute the most to facial landmark disfigurement in facial paralysis. 2 The NLF is created by the insertion of upper lip elevators into the dermis.…”

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“…The NLF is formed by the muscular projections of the upper lip elevators and the fibrous tissue that connect the smiling mechanism to the dermis of the skin in the fold. 1 Numerous methods have been described to reduce the NLF, which characteristically deepens with age, or to recreate it when it is typically effaced in patients with facial paralysis. Bhama et al 3 described a technique to reconstruct the NLF in the setting of facial paralysis.…”

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Minimal Nasolabial Incision Technique for Nasolabial Fold Modification in Patients With Facial Paralysis

Faris

Heiser

Jowett

et al. 2018

JAMA Facial Plast Surg

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nasolabial folds (NLFs) is important in the management of the paralyzed face. Established techniques use a linear incision in the NLF, and technical refinements now allow the linear incision to be omitted. DESIGN, SETTING, AND PARTICIPANTSThis retrospective case series was conducted in a tertiary care setting from February 2, 2017, to June 7, 2017. Participants were all patients (N = 21) with peripheral facial paralysis who underwent NLF modification that used the minimal nasolabial incision technique at the Massachusetts Eye and Ear Infirmary Facial Nerve Center from February 1, 2015, through August 31, 2016.MAIN OUTCOMES AND MEASURES Patient-reported outcome measures using the validated, quality-of-life Facial Clinimetric Evaluation (FaCE) Scale; clinician-reported facial function outcomes using a validated electronic clinician-graded facial paralysis assessment (eFACE); layperson assessment of the overall aesthetic outcome of the NLF; and expert-clinician scar assessment of the NLF. RESULTSOf the 21 patients who underwent NLF modification that used the minimal nasolabial incision technique, 9 patients (43%) were female and 12 (57%) were male. The mean age was 41 (range, 9-90) years; 17 patients (81%) were adults (Ն18 years) and 4 (19%) were children (<18 years). Overall, significant improvements were observed after NLF modification in all outcome measures as graded by both clinicians and patients. The mean (SD) scores for total eFACE were 60.7 (14.9) before the operation and 77.2 (8.9) after the operation (mean difference, 16.5 [95% CI, 8.5-24.2]; P < .001). The mean (SD) static eFACE scores were 61.4 (20.6) before the operation and 82.7 (12.4) after the operation (mean difference, 21.3 [95% CI, 10.7-31.9]; P < .001). The mean (SD) FaCE quality-of-life scores were 51.3 (20.1) before the operation and 70.3 (12.6) after the operation (mean difference, 19.0 [95% CI, 6.5-31.6]; P = .001). The layperson self-assessment of the overall aesthetic outcome of the NLF modification was higher among the group who had the minimal nasolabial incision than it was for the group who had a historical nasolabial incision (mean [SD], 68.17 [13.59] vs 56.28 [13.60]; mean difference, 11.89 [95% CI,; P < .001). Similarly, the expert-clinician scar assessment of the NLF modification was higher for the group who had the minimal nasolabial incision than it was for the group who had a historical nasolabial incision (3.78 [0.91] vs 2.98 [0.81]; mean difference, 0.80 [95% CI, 0.29-1.32]; P = .007). CONCLUSIONS AND RELEVANCEThe minimal nasolabial incision technique for NLF modification is effective in rehabilitating the NLF in facial paralysis without adding a long linear scar to the central midface.LEVEL OF EVIDENCE 4.

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confidence: 99%

mentioning

confidence: 99%

Minimal Nasolabial Incision Technique for Nasolabial Fold Modification in Patients With Facial Paralysis

Faris

Heiser

Jowett

et al. 2018

JAMA Facial Plast Surg

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Gummy smile: clinical parameters useful for diagnosis and therapeutical approach

Monaco

Streni

Marci

et al. 2005

Journal of Clinical Pediatric Dentistry

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In the analysis of the characteristics of a pleasant smile, a gummy smile has negative components, which most affect the esthetics of non-verbal communication. For this purpose a proposed classification based upon etiopathogenetic criteria as useful indications for a therapeutical approach is given.The nature of a high smile line can be: dento-gingival, connected to an abnormal dental eruption, which is revealed by a short clinic crown; muscular, caused by an hyperactivity of the elevator muscle of the upper lip; dento-alveolar (skeletal), due to an excessive protuberance or vertical growth of the jawbone (maxillary); lastly, a mixed nature, in the presence of more than one of the above described factors.The diagnosis of gummy smile must be precocious and based, with reference to specific parameters, upon a careful analysis of the etiopathogenetic factors and the degree of seriousness of the alteration. A correct treatment plan must contemplate the possibility of an orthognatodontic, orthopedic and/or surgical therapeutic resolution considering the seriousness and complexity of the gums exposures (high smile line) in connection with the age of the subject.

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Botulinum Toksinin Gummy Smile Tedavisinde Kullanımı

GÜRBÜZ

KAÇAR

2024

Sağlık Akademisi Kastamonu

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Clostridium botulinum adlı bakteri tarafından üretilen botulinum toksinin terapötik etkisi kolinerjik nöron sinapslarında asetilkolin salınımını bloke etmesinden ve kas kontraksiyonuna engel olmasından kaynaklanmaktadır. Terapötik amacın yanı sıra kozmetik amaçla da uygulanan botulinum toksinin kullanımı oftalmoloji, gastroenteroloji, üroloji, ortopedi ve dermatoloji gibi birçok medikal alana yayılmıştır. Baş ve boyun bölgesinde trigeminal nevralji, migren, larenjektomi sonrası özofageal konuşma, fasiyal sinir paralizi, siyalore, temporomandibular eklem bozuklukları, bruksizm, çiğneme kaslarında miyalji ve hemifasiyal spazm gibi birçok durumda terapötik amaçla kullanılmaktadır. Botulinum toksini aynı zamanda gummy smile, gülme asimetrisi, unilateral masseter hipertrofisine bağlı gelişen fasiyal asimetri gibi perioral kozmetik durumlarda da başarıyla kullanılmaktadır. Hiperaktif dudak kaslarının neden olduğu gummy smile tedavisinde botulinum toksini enjeksiyonu, uygulama kolaylığı ve güvenliği açısından minimal invaziv bir yaklaşım olarak tercih edilmektedir. Bu derlemede, botulinum toksinin gummy smile tedavisinde kullanımına dair güncel literatür bilgilerine yer verildi.

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Anatomy of the Nasolabial Fold

Cited by 5 publications

References 0 publications

Minimal Nasolabial Incision Technique for Nasolabial Fold Modification in Patients With Facial Paralysis

Minimal Nasolabial Incision Technique for Nasolabial Fold Modification in Patients With Facial Paralysis

Gummy smile: clinical parameters useful for diagnosis and therapeutical approach

Botulinum Toksinin Gummy Smile Tedavisinde Kullanımı

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